Comparison of a predefined dose increment nomogram with a percentage adjustment nomogram in patients receiving argatroban therapy
| Autor: | Douglas Bloomstein, Anjali Kakwani, Kunal J. Shah, Dhara D. Shah |
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| Rok vydání: | 2019 |
| Předmět: |
Pharmacology (nursing)
Pharmacy Arginine 030226 pharmacology & pharmacy Tertiary care Argatroban 03 medical and health sciences 0302 clinical medicine Therapeutic index medicine Humans In patient 030212 general & internal medicine Retrospective Studies Pharmacology Sulfonamides medicine.diagnostic_test business.industry Heparin Significant difference Anticoagulants Nomogram Thrombocytopenia Nomograms Sample size determination Anesthesia Pipecolic Acids business circulatory and respiratory physiology medicine.drug Partial thromboplastin time |
| Zdroj: | Journal of the American Pharmacists Association : JAPhA. 60(5) |
| ISSN: | 1544-3450 |
| Popis: | Objective To determine the compliance with a predefined dose increment (PDI) nomogram compared with a percentage adjustment (PA) nomogram for the dose titration of argatroban therapy. Design This was a single-center, retrospective chart review. Setting and participants This study was conducted in a tertiary care teaching hospital. Patients were included if they received argatroban from 2013 to 2016. Outcome measures The primary safety outcome was the percentage of appropriate dose titrations. The secondary safety and efficacy outcomes included the median time to therapeutic activated partial thromboplastin time (aPTT), the median argatroban dose once therapeutic, and the median time in the therapeutic, subtherapeutic, and supratherapeutic aPTT ranges, as well as the bleeding and thrombotic events during hospitalization. Results Seventy-seven patients were included in the study. There was no statistically significant difference in the percentage of titrations performed appropriately (P = 0.17). The median time to goal aPTT, the dose when first therapeutic, and the time aPTT was subtherapeutic were similar in both the arms. The patients in the PDI arm were on argatroban for a median time of 55 hours compared with 110.5 hours for the patients in the PA arm (P = 0.001). The patients in the PA arm spent more time in the therapeutic range (P Conclusion Although there was no difference in the percentage of appropriate dose titrations, the patients in the PA arm spent more time on argatroban, had greater time in the therapeutic aPTT range, and had less time in the supratherapeutic aPTT range. Future studies that include a larger sample size, matching therapeutic aPTT ranges, and similar initial infusion rates would help evaluate further the outcomes between the PDI and PA nomograms. |
| Databáze: | OpenAIRE |
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